How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,072 to $10,965Professionalmedian $3,162 · 10th to 90th $2,239 to $3,981
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,290.87 | $3,715.35 | $3,715.35 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,606.93 Median $7,585.78 Typical High $12,022.64 | Facility | None | $6,606.93 | $7,585.78 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $3,630.78 | Professional | None | $2,884.03 | $3,388.44 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,445.44 | Facility | None | $954.99 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $2,818.38 | Professional | None | $2,187.76 | $2,511.89 | $2,818.38 |
Moda Health Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $5,495.41 | Facility | None | $1,513.56 | $3,715.35 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,715.35 Typical High $4,365.16 | Professional | None | $2,290.87 | $3,715.35 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2,570.40 Median $3,162.28 Typical High $3,162.28 | Facility | None | $2,570.40 | $3,162.28 | $3,162.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,981.07 | Professional | None | $3,162.28 | $3,162.28 | $3,981.07 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $10,000.00 Typical High $12,589.25 | Facility | None | $7,585.78 | $10,000.00 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,090.30 Median $3,630.78 Typical High $4,365.16 | Professional | None | $3,090.30 | $3,630.78 | $4,365.16 |
Select Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,584.89 | Facility | None | $1,513.56 | $1,513.56 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $1,513.56 Typical High $2,754.23 | Professional | None | $977.24 | $1,513.56 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $2,691.53 Typical High $3,890.45 | Professional | None | $1,995.26 | $2,691.53 | $3,890.45 |
23 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,148.15 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $457.09 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,737.80 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $346.74 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $229.09 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,621.81 | $2,570.40 | $2,570.40 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $9,772.37 Median $11,481.54 Typical High $18,197.01 | Facility | 50 · Both sides | $9,772.37 | $11,481.54 | $18,197.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $4,365.16 Median $4,897.79 Typical High $5,248.07 | Professional | 50 · Both sides | $4,365.16 | $4,897.79 | $5,248.07 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,951.21 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,630.27 | $2,951.21 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $323.59 Typical High $354.81 | Professional | 55 · Aftercare only | $288.40 | $323.59 | $354.81 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,819.70 Median $2,041.74 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,819.70 | $2,041.74 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,467.37 Median $3,890.45 Typical High $4,265.80 | Professional | 63 · Small infant | $3,467.37 | $3,890.45 | $4,265.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,290.87 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,290.87 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $467.74 Median $524.81 Typical High $562.34 | Professional | 80 · Assistant surgeon | $467.74 | $524.81 | $562.34 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $467.74 Median $524.81 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $467.74 | $524.81 | $562.34 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $467.74 Median $524.81 Typical High $562.34 | Professional | 82 · Assistant surgeon, no resident | $467.74 | $524.81 | $562.34 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $446.68 Typical High $478.63 | Professional | AS · PA/NP assist | $398.11 | $446.68 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,148.15 | $1,862.09 | $1,862.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $457.09 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,737.80 | $2,754.23 | $2,754.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $346.74 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $229.09 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,621.81 | $2,570.40 | $2,570.40 |
Where Idaho sits
The same service costs 18.6 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 11th of 51
$3,162
AK $7,413TX $398
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.